190242 09/29/2010 CITY OF CARMEL, INDIANA VENDOR: 364734 Page 1 of 1
ONE CIVIC SQUARE DAWNE DAVIS
CARMEL, INDIANA 46032 4486 REPASS DRIVE CHECK AMOUNT: $87.00
WESTFIELD IN 46074
CHECK NUMBER: 190242
CHECK DATE: 9/29/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1096 4358400 87.00 PARKS DEPARTMENT REFU
ACTIVITY REFUND RECEIPT
Receipt 523704
Payment Date: 09/23/10
Household 21396
Monon Community Center Dawne Davis Hm Ph: (317)344 -2157
Carmel IN 46032 4486 Repass Drive Wk Ph: (317
Westfield IN 46074 Cell Ph:
dawnemdavis@att.net
Phone: (317)848 -7275
Fed Tax ID #35- 6000972
Enrollment Details
CANCELLATION Refund Of 87.00
Enrollee Name: Kevin Davis Fees Tax Discount Prev Paid Cur Paid Amount Due
Activity Number: 207600 -02 The MCC Fall Open 0.00 0.00 0.00 0.00 0.00
Enrollment Date: 08/25/2010 (Cancelled)
Class Location: Gymnasium A Class Dates: 09/25/2010 to 09/25/2010
Monon Community Cntr 8:OOA to 6:OOP
Sa
Carmel, IN 46032 Scheduled Sessions: 1
(317)848 -7275
Cancel Reason: low enrollment
PREVIOUS NET HOUSEHOLD BALANCE 0.00
Processed on 09/23/10 11:15:12 by MML FEES CHANGED ON CANCELLED ITEMS 87.00
NET AMOUNT FROM CANCELLED ITEMS 87.00
TOTAL AMOUNT REFUNDED 87.00
NEW NET HOUSEHOLD BALANCE 0.00
Refund of 87.00 Made By REFUND FINAN With Reference low enrollment
All refunds are subject to State Board of Accounts claim procedure and may take 4 -6 weeks to process. A check will be
issued. No cash or credit card refunds.
2 i6 9.23.10
Authorized Signature Da y orized gnature Date
The Monon Community Center is a one -stop shop! Why drive all day searching for your local garage sale? Come to our
Community Garage Sale and leisurely browse through all sorts of items. The Community Garage Sale will take place Saturday,
October 9 from 1 Oam -4pm at the MCC East Parking Lot. The event is free to the public.
Vendors: The fee for vendors is $5 /parking space. You must bring a table /chair. A limited number of tables and chairs will be
available at an additional cost of $5 each. In case of inclement weather, this event will be cancelled. To register, please
contact Sarah or fax your form to 317.573.5243.
T iT GY
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ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
An invoice of bill to be properly itemized must show; kind of service, where performed, dates service rendered, by
whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc.
Payee
Purchase Order No.
Davis, Dawne Terms
4486 Repass Drive Date Due
Westfield, IN 46074
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
9123110 523704 Refund 87.00
Total 87.00
I hereby certify that the attached invoice(s), or bill(s) is (are) true and correct and I have audited same in accordance
with IC 5- 11- 10 -1.6
20_
Clerk- Treasurer
Voucher No, Warrant No.
Davis, Dawne Allowed 20
4486 Repass Drive
Westfield, IN 46074
In Sum of
87.00
ON ACCOUNT OF APPROPRIATION FOR
109 Monon Center
PO# or Board Members
INVOICE NO. ACCT #/TITLE AMOUNT
Dept
1096 -50 523704 4358400 87.00 1 hereby certify that the attached invoice(s), or
bill(s) is (are) true and correct and that the
materials or services itemized thereon for
which charge is made were ordered and
received except
27 -Sep 2010
Signature
87.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund